Drama & Delivery

Few events rival the experience of childbirth, for both parents and student nurses.

So for students learning to care for patients during childbirth, the University at Buffalo School of Nursing set out to examine which simulation provided the more authentic experience: one with computerized manikins or live actors portraying mothers.

The research, titled “Noelle or Mama Natalie: Does Type of Simulator Impact Confidence, Satisfaction and Performance in a Simulated Learning Experience,” was led by Deborah Raines, PhD, EdS, RN, ANEF, and Jennifer Guay, DNP, RN, associate professor and clinical assistant professor in the School of Nursing, and W. Scott Erdley, DNS, RN, CHSE, special projects simulation educational specialist at the UB Behling Simulation Center.

After realizing that UB nursing students enrolled in maternal newborn practice courses were more focused on eliciting a response from the manikin than performing necessary nursing actions such as repositioning, touching, making eye contact or communicating, faculty began asking the question: Is a high-technology manikin the best device for a simulation experience?

Noelle, the full-bodied, computerized manikin utilized by UB, can speak, allow students to measure vital signs, facilitate birth and more. But it is also motionless, unable to change positions or facial expressions.

To complete the study, the researchers had groups of students carry out birth simulations at the Behling Simulation Center, one cohort with Noelle, and another with a paid, live actor equipped with the Mama Natalie, a low-technology simulator that can release fluids and deliver a fetus.

The research tested more than 130 nursing students and more than 30 medical students in the Jacobs School of Medicine and Biomedical Sciences. Each simulation included a crisis event, where either the patient begins to hemorrhage or the fetus’s heart rate drops.

After each simulation, students reported their perceived selfconfidence and satisfaction with their performance. The results found that the majority of students experienced greater satisfaction and confidence when performing the simulation with an actor, with many citing the ability to gather visual cues and communicate with a living person as a benefit.

However, despite the benefits of live actors and the high-cost of computerized manikins, Noelle has its advantages, she says.

Unlike the manikin, a live actor can’t alter their blood pressure or develop physical responses to medications, since students also can’t inject the actors with needles or syringes. Matching the context of the simulation to learning objectives is critical, says Raines.

Raines and Guay presented preliminary findings at the Sigma Theta Tau International 43rd Biennial Convention and plan to publish their results in the future.

The research was funded by the Patricia H. Garman Behavioral Health Nursing Endowment Fund.

-MARCENE ROBINSON